A few things on the West Virginia strike

Farzad Mostashari went into the weeds to look at the price drivers in the state employee health plan that is the basis of the current teacher strike.  He sees two big things that stood out to him.

It seems like the PEIA is doing a good job of keeping a many people as possible out of the hospital. Managed care entities including HMOs, ACOs, SSP, ASO and several other three letter acronyms will usually try to divert people out of hospitals and to some other location that can’t bill with a hospital code. Yet it is still a matter of prices. The hospitals are doing a lot less and still getting paid more. What is going on here?

I want to thank Farzad for chasing the data as this is meaningful and illuminating as to what the strike actually boils down to.

15 replies
  1. 1
    foucault swing voter mistermix says:

    Rural hospitals raising prices because they have large fixed overhead?

  2. 2
    Snoopy says:

    “(as) many people ass possible out of the hospital”

    If that’s a freudian slip, it’s a wonderful one…

  3. 3
    laura says:

    What the strike boils down to is that people can’t afford a yearly pay cut. Stagnant wage growth and rising healthcare costs and rich fuckers who refuse to pay a fair share of taxes.
    The American dream is a nightmare and George Carlin was right.

  4. 4

    Have you looked at the morbidity profile of those drugs, though?

    Humira Autoimmune
    Enbrel Autoimmune
    Copaxone Autoimmune, esp. MS
    Tecfidera MS
    Xyrem (GHB) Narcolepsy
    Norditropin (growth hormone)
    Growth hormone deficiency
    Gilenya MS
    Revlimid Multiple myeloma (cancer)
    Otezla Autoimmune
    Harvoni Hep C

    Why so much MS? Are we looking at an environmental health problem, here? Hep C is blood borne – is this a consequence of drug abuse? Norditropin (growth hormone)? Another environmental health problem?

    Say, what?

  5. 5
    dr. bloor says:

    @foucault swing voter mistermix: Yahtzee. It costs X to keep a hospital open. If they ain’t doing volume, it’s going to be reflected in the price tag.

  6. 6
    Cowboy Diva says:

    It seems like the PEIA is doing a good job of keeping a many people ass [sic] possible out of the hospital.

    Wasn’t there a comment from a teacher in a recent article about just how intrusive and punishing PEIA was about preventive care, as well as a complete disregard for genetic versus personal responsibility for cholesterol levels, etc?

  7. 7
    Buskertype says:

    this is very interesting, thanks!

  8. 8
    Old Scold says:

    The only good hospital is an empty hospital.

  9. 9
    gvg says:

    David, is this unique to WV or is it widespread?

  10. 10
    NorthLeft12 says:

    @Cowboy Diva: LG&M have a good article up that has some feedback from a teacher regarding why she went on and supported the strike.
    My company has also converted the wellness program to one of these intrusive monitoring programs [Virgin Pulse] that I tried to participate in but gave up after a couple of weeks. I don’t have a cel phone or one of those watches, so I had to enter everything manually. I frankly don’t have the time or inclination to jump through these hoops for some minor financial awards.
    I am lucky that I am paid enough that I can afford to do that. I know that others [due to their financial situation] must participate. I have asked a few of the upper management folks why they switched to this system. The leaders that I know well and they know me, get the question framed in this way; “Who is the genius that came up with this idea?”

  11. 11
    Villago Delenda Est says:


    The leaders that I know well and they know me, get the question framed in this way; “Who is the genius that came up with this idea?”

    The same geniuses who thought a global chat channel was a good idea in World of Warcraft.

  12. 12
    Duane says:

    Whatever happens, we can’t raise taxes one iota to pay for things. Let it go to hell, turn the asphalt into gravel, nothing can be done. The enemy truly is ridiculous.

  13. 13
    NorthLeft12 says:

    @Villago Delenda Est: The Leaders don’t admit it, but I believe this new system is a cost savings for the company, and is just something new that they or some other executive can take credit for implementing and thus justify a bigger bonus.

  14. 14
    Fair Economist says:

    @Raven Onthill: MS is probably due to an infectious agent, with the symptoms probably secondary to the infection (which is to say, people with MS are people who *had* the disease, but don’t have it anymore).

    Hep C is primarily via IV drug abuse, although there is substantial sexual transmission. It’s most common in older adults because needle exchange programs became more common in the late 20th century so transmission has dropped.

    Growth hormone deficiency is generally genetic, although there is the possibility of abuse.

  15. 15
    Matt says:

    @Raven Onthill: The covered population has lived most of their lives in an open-air toxic waste dump thanks to the mining industries. Wouldn’t be a shock.

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